The effectiveness of a tobacco prevention program with adolescents living in a tobacco-producing region.

OBJECTIVES: This study investigated the efficacy of a social-influences tobacco prevention program conducted with adolescents living in a high tobacco production area. METHODS: Students in 10 experimental schools completed the tobacco prevention program and a booster intervention. Control students received health education as usual. RESULTS: After 2 years of treatment, smoking rates in the treatment group (vs the control group) were lower for 30-day, 7-day, and 24-hour smoking. The intervention had more of an impact on those who were involved in raising tobacco than it did on those not involved in raising tobacco. CONCLUSIONS: Although modest, effects were achieved with minimal intervention time in a high-risk group, indicating that social-influences prevention programs may be effective in such groups.

Relationship of personal tobacco-raising, parental smoking, and other factors to tobacco use among adolescents living in a tobacco-producing region.

This study examined factors related to tobacco use among youth from tobacco-raising (TRH) and nonraising households (NRH). The subjects were 3,851 seventh-grade students from 19 middle schools located in a tobacco-raising region. Valid self-reports of tobacco use were encouraged by the use of a test for carbon monoxide in expired air. Cigarette use was higher when (a) at least one parent smoked, and/or (b) the student personally raised tobacco. A boy who personally raised tobacco and had at least one parent who smoked was 10.2 times more likely to have smoked in the last 7 days than a boy from a nonraising household in which neither parent smoked. For girls, the odds ratio was 5.6:1. Tobacco use among students in this high-risk group was higher than rates reported in national or regional studies. Other results were: (1) use began very early--16% of the students had tried cigarettes and 13% of the boys had tried smokeless tobacco (SLT) in Grade 3 or earlier; and (2) users reported more lenient rules at home regarding tobacco use than did nonusers. Years from now, these high-risk students are likely to be major contributors to increased morbidity and mortality due to tobacco use. Implications for tobacco prevention in tobacco-raising areas are discussed.

Use of snuff, chewing tobacco, and cigarettes among adolescents in a tobacco-producing area.

This study describes the prevalence and patterns of smokeless tobacco and cigarette use among adolescents with a specific focus on those living in a high tobacco production area. The subjects were 582 male and 485 female students in grades 7 through 12, with 54% living in a rural (nonmetro) area and the remainder living in an urban (metro) area. Self-reports of tobacco usage were validated using biochemical tests. High smokeless tobacco usage rates were found among nonmetro males--90% had tried one or more smokeless tobacco products and 33% had used at least one of the products in the last 6 days. Students' tobacco usage increased dramatically as the degree of personal involvement in raising tobacco increased. Of senior high boys who had household involvement in tobacco, 100% had tried snuff and 42% had used it in the last 6 days; 80% had tried cigarettes and 53% had used them in the last 6 days. Some other results were: (1) use of snuff was more popular than chewing tobacco, (2) the average grade for initiation to tobacco was the fourth grade for nonmetro students and the fifth grade for metro students, and (3) a large number of male smokeless users also reported cigarette use. Students from tobacco-raising households are at high risk for tobacco use. Future research should focus on effective prevention methods for high-risk students.

The effects of self-monitoring and reinforcement on exercise adherence.

Two behavioral techniques were assessed to determine their effects on subjects' adherence to unsupervised exercise. The subjects were 35 moderately fit persons who had just completed an adult fitness program (AF group) and 42 sedentary individuals who were recruited through the campus newspaper (NEWS group). Participants were randomly assigned to one of three conditions: (a) self-monitoring, (b) reinforcement supplied by another person, or (c) control. All subjects were given instructions on how to exercise and asked to exercise on their own for 18 weeks. Self-monitoring subjects kept written records of their exercise behavior, while reinforcement subjects verbally reported their exercise behavior to another person who periodically administered rewards. Pre- and posttreatment tests on the NEWS group revealed no significant treatment or interaction effects. However, the reinforcement group had an 11% improvement in predicted max VO2 and a 9 bpm improvement in exercise heart rate compared to 7.8%, 5 bpm for the self-monitoring (SM) group and 5.3%, 6 bpm for the control group. T-tests indicated that reward and SM groups improved significantly on these variables, whereas the control group did not. SM (M = 2.07) and reinforcement (M = 2.29) groups reported a significantly higher frequency of exercise per week than the control (M = 1.36) group. The AF subjects were able to maintain their fitness level (with the exception of a small increase in body fat) over the 18-week period. The behavioral interventions had little differential effect on adherence by AF subjects who were already regular exercisers.

Saliva cotinine and thiocyanate: chemical indicators of smokeless tobacco and cigarette use in adolescents.

Recent attempts to measure smoking behavior using chemical tests may have been confounded by the use of smokeless tobacco. An objective measure of smokeless tobacco use is needed, particularly among adolescents who may not provide accurate self-reports of tobacco usage. Saliva cotinine was used to distinguish self-reported tobacco users from nonusers and a combination of saliva cotinine and thiocyanate (SCN) tests was used to distinguish smokers from smokeless tobacco users. The subjects were 471 students in grades 7 through 11 who lived in a high-tobacco production area. Approximately 89% of reported nonusers had no detectable cotinine and 99% of nonusers had levels less than 25 ng/ml. Of those who had used tobacco within the last 12 hr, 95% had detectable levels of cotinine. Samples that tested positive for cotinine were also tested for SCN. Eighty-six percent of smokers and 74% of mixed users had SCN values of greater than 1000 mumol/liter, while only 14% of smokeless users had SCN values at that level. The combination of cotinine and SCN was effective in distinguishing smokers from smokeless users but was not effective in distinguishing mixed use from the other two types of use.

Recovery of dynamic muscular endurance.

Recovery of the rate of dynamic muscular endurance was measured in two groups of college-aged males. Subjects were required to perform elbow flexion (between the angles of 70 and 170 degrees) for as long as possible at the rate of 38 contractions/min while loaded with 1/6 of their maximum isometric strength (MVC). The task was terminated when the subject fell four contractions behind the required cadence or failed to complete two successive contractions. Subsequent to the task the subject was given a predetermined rest period after which a second fatigue bout to failure was performed. The rest intervals for Gp I (n = 22) were 5, 15, 45, 135, 405, and 1215 seconds, while the rest intervals for Gp II (n = 17) were 10, 30, 90, 270, 810, and 2550 s. Each subject completed six recovery intervals with the order of administration assigned at random. The percentage of recovery was calculated by dividing the exercise time of the first bout into the time of the second bout. These normalized data for the two groups were combined for analysis providing a 12 point recovery curve. The percentage of recovery ranged from 15.4% after 5 s to 91.8% after 2550 s. Analysis of the data revealed that the recovery pattern of dynamic muscular endurance progressed very rapidly initially, reached 50% at approximately 2 min and 15 s and was slightly less than 90% complete at 20 min. Exponential analysis of these data yielded a three-component curve.

Factors related to the health knowledge and health behavior of disadvantaged black youth.

The purpose of this study was to investigate the relationship between various factors and the health knowledge and health behavior of disadvantaged black youth. Disadvantaged black male and female youths, age 12 to 17, were surveyed regarding their health knowledge, health locus of control, and health practices. Results of the data analyses using an ANOVA revealed significant differences for scores on the health knowledge test due to sex, age, and health locus of control. Females had higher test means than males, older students had higher knowledge scores than did younger students, and internally-oriented students had higher knowledge scores than did externally-oriented students. No significant interaction was found. An ANOVA on behavior scores revealed a sex by locus of control interaction. Male externals had much lower behavior scores than female externals. A significant interaction also was found between age and health locus of control. Older externals had significantly higher behavior scores than younger externals. Implications for health educators and nurse educators are discussed.

Treating the spiritual dimension through educational imagery.

Recently, health educators have shown an interest in the spiritual dimension of health. Despite this interest, most health educators have taken the "safe" approach and avoided the discussion of spiritual issues in the classroom. The problem with this avoidance position is that sensitive issues such as sexuality, drug use, and death and dying are laden with spiritual implications, particularly when students are asked to make personal decisions regarding these issues. The present article suggests the use of Educational Imagery as a method for incorporating the spiritual dimension into the health lesson. When certain simple precautions are taken, the educational imagery technique applied to the spiritual dimension can be both useful in meeting educational objectives and in making the classroom exciting and interesting for the students. The reader is provided with a definition of the spiritual dimension, along with a complete description of Educational Imagery. In addition, specific strategies for incorporating spiritual health in the classroom are given. The final section of the article includes implications and precautions for the teacher.

Awareness, knowledge and perceived risk for toxic shock syndrome in relation to health behavior.

The purpose of this investigation was to determine the relationship of awareness, knowledge and perceived risk for toxic shock syndrome (TSS) in relation to health behavior. Female college students at a large urban university responded to an 18-item multiple choice questionnaire. The data obtained revealed a high awareness among the 306 subjects who participated in the study, yet many of these women lacked essential knowledge about TSS. Perceived knowledge and perceived risk for developing TSS were significantly related to: (1) menstrual product used before an awareness of TSS; (2) menstrual product presently used; and (3) changing menstrual products due to a concern for TSS. Actual knowledge was also found to be related to the subjects' changing menstrual products due to a concern for TSS. Twenty-one percent of the subjects in this study actually did change their health behavior due to a concern for TSS.